title: Impacts of age on coronary atherosclerosis and vascular response to statin therapy.
abstract: Age is a well-established risk factor for cardiovascular disease. Recent trials using intravascular ultrasound (IVUS) have shown that lipid-lowering therapy with statins halts the progression or induces the regression of coronary artery plaques. However, impacts of age on coronary atherosclerosis and vascular response to statin therapy have not been fully evaluated. The effects of 8-month statin therapy on coronary atherosclerosis were evaluated using virtual histology-IVUS. IVUS data were analyzed from 119 patients who were divided into two groups according to age: elderly patients (≥65 years, n = 72) and non-elderly patients (<65 years, n = 47). No patients were taking statins or other lipid-lowering therapies at baseline. At baseline, external elastic membrane (EEM) volume (17.27 vs. 14.95 mm(3)/mm, p = 0.02) and plaque volume (9.49 vs. 8.11 mm(3)/mm, p = 0.03) in the elderly patients were significantly greater than in the non-elderly patients. The EEM volume (-2.4 %, p = 0.007) and plaque volume (-3.1 %, p = 0.007) after 8-month of statin therapy had significantly decreased in the non-elderly patients but not in the elderly patients. A significant positive correlation was observed between age and percentage change in plaque volume (r = 0.265, p = 0.004). A multivariate regression analysis showed that age was a significant predictor of the percentage change in plaque volume during statin therapy (β = 0.223, p = 0.02). Coronary atherosclerosis was more advanced and vascular responses to statin therapy were attenuated in the elderly patients compared to the non-elderly patients.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, 132 Katsura-cho, Sakae-ku, Yokohama, 247-8581, Japan, nozue2493@yahoo.co.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nozue
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tohyama
authors.forename: Kazuki
authors.initials: K
authors.lastname: Fukui
authors.forename: Shigeo
authors.initials: S
authors.lastname: Umezawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Onishi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kunishima
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nozato
authors.forename: Shogo
authors.initials: S
authors.lastname: Miyake
authors.forename: Youichi
authors.initials: Y
authors.lastname: Takeyama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Morino
authors.forename: Takao
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hirano
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Michishita
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors